A Systematic Study on the Prevalence of Alcohol and Marijuana use in Pregnant Women with Opioid Use Disorder

Abstract

Approximately 25% of pregnant women drink alcohol, 7.4 out of 1000 deliveries are affected by opioid use disorder (OUD), and cannabis use is on the rise among pregnant women. Despite this, there is little information about marijuana co-exposure in women who use multiple substances. Using the well-characterized ENRICH-1 cohort, which studied the effects of two primary exposures of interest-opioids and alcohol-the authors estimated the prevalence of marijuana use in those with OUD and or alcohol use and also examined correlates of marijuana use in those with OUD and or alcohol use. There were 194 participants with OUD, 100 with alcohol, and 94 with both OUD and alcohol. Based on self-reports and biomarkers, substance abuse was determined. The correlation between marijuana uses and multivariate logistic regression was identified. According to the OUD, OUD + alcohol, and alcohol groups, 46%, 52%, and 49% of pregnant women used marijuana. 20%, 22%, and 26% of participants reported weekly or daily use. Compared to women who took methadone (38%), those who took buprenorphine (46% and 60%, respectively) were significantly more likely to use marijuana. Marijuana users were generally younger than non-marijuana users in all three groups. There was a significant association between maternal age, and polysubstance use independent of group, race/ethnicity, education, and smoking. It was found that there was a significant interaction between partnership status and group: women in the OUD and OUD + alcohol groups had lower odds of marijuana use than those in the alcohol group. Women in the alcohol group who were partners had lower odds of using marijuana than women who were unpartnered. The authors conclude that women who are treated for OUD during pregnancy and or who consume alcohol during pregnancy are more likely to use marijuana. As a result of these findings, ongoing risk reduction strategies are needed for pregnant women receiving OUD treatment as well as pregnant women exposed to alcohol.